More Than Anxiety?

By Kristina Randle, Ph.D., LCSW

I am anxious all the time, but I’m worried it might be something more than just anxiety. I am really dealing with two issues – greif and loss and anxiety. I lost my daughter in November last year (2008). Ever since that happend I had been smoking alot of weed. I would have been stoned everyday. In January this year (2009)I experienced a minor psychotic episode that lasted about 2 days. Ever since then I have been experiencing extreme levels of anxiety and panic attacks. Although the panic attcks and no where near as servere as they used to be and they are few and far between now. My anxiety did die down for a while, when I started CBT. But the 4th April 09 was my expected due date and the week leading up to that I could feel my anxiety rising and feeling myself getting really down. I will be going back to greif and loss counseling and 2 weeks time. But in the mean time my anxiety has reached a point where it is almost unbearable. During the day I am pretty much anxiety free or if I am anxious I seem to be able to control it better during the day. But at night I can’t control it, CBT is useless. I have started to have trouble sleeping again. I am just so scared that I will have another psychotic episode even though I have been told by my GP, Counselor and Physiatrst that they seriously doubt I will have another one, I can’t seem to shake the fear. It’s constantly on my mind and sometimes I imagine that I am going into one again and I also imagine that normal objects are rushing towards me because that’s what was happening during the episode and it’s scares the hell out of me when I do this. I don’t feel ‘normal’ anymore. It’s kind of a feeling that my mind is stuck between the episode and ‘sane’. Am I just extremely anxious or is there something else wrong with my thoughts?

Thanks, Melissa

A. Dear Melissa, you asked if I could judge whether you’re experiencing anxiety or psychosis. Without much more information it’s difficult to make that judgment. Based on the opinion of your counselor and doctor, it’s anxiety that you’re experiencing and not psychosis. I know you are frightened of having another episode but I would encourage you to listen and trust what they say. They are familiar with your case. As long as you are being honest with them about your symptoms and are following their orders then you’re probably going to be fine, just as they’ve said. Believe in what they say and have confidence.

Having one episode of psychosis does not mean that you’ll have another. Some people have a psychotic episode in response to a traumatic event but never have that experience again. Your psychotic episode may also have been related to your use of drugs. Drug use, including marijuana, has been linked to psychosis. It could have been a combination of the trauma and the drug use. It’s often difficult to sort out the truth. Your treatment team believes that you are experiencing anxiety and not psychosis. Again, if that is what they think then they are probably correct.

You mentioned that you are having extreme anxiety at night. Perhaps you could ask your treating mental health professionals for a temporary trial of medication (or an increase in medication if you are already on medicine) that could help you decrease the anxiety. You could take the medicine on an as-needed basis. Maybe you’ll only need it for a short time or at least until you meet with you grief and loss counselor. Medications classified as benzodiazepines can help temporarily reduce anxiety and reduce insomnia if you are having difficulty sleeping. You may want to ask about this.

I am glad you are seeking counseling from your loss. It’s good to hear that you have already connected with a counselor and a psychiatrist. You are doing what you need to do to deal with your loss. This is very encouraging. Stay away from illegal drugs, focus on the positive, follow the advice of your counselors and doctors and if you do, there is a very good chance your anxiety will dissolve and your life will improve. Keep me posted on your progress.

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Last reviewed: By John M. Grohol, Psy.D. on 20 Apr 2009

APA Reference
Randle, K. (2009). More Than Anxiety?. Psych Central. Retrieved on December 19, 2014, from http://psychcentral.com/ask-the-therapist/2009/04/20/more-than-anxiety/